HFORM07: Change Request Form¶
Form Reference: HFORM07 Version: 1.0 Classification: CRGI Information Form Owner: Sean Ashton, Operations Manager Purpose: Management of Change (MoC) form per HPROC07. Evaluates impact and risk of changes to processes, documents, systems, equipment, organizational structure or scope before implementation.
Document Control¶
| Version | Date | Author | Change Summary |
|---|---|---|---|
| 1.0 | 10/03/2026 | Sean Ashton | Initial issue |
1. Request Details¶
| Field | Details |
|---|---|
| Change Request (CR) Reference | CR-YYYY-___ |
| Date Requested | _________________ |
| Requester Name | _________________ |
| Requester Role | _________________ |
Change Type (select one)¶
☐ Process (workflow, procedure, method) ☐ Document (policy, procedure, work instruction, template) ☐ Equipment (tools, software, hardware, machinery) ☐ Software (application, system, version upgrade) ☐ Organisational (staffing, structure, roles, reporting) ☐ Scope (service scope, client work, responsibility) ☐ Other: _________________
Priority Level¶
☐ Urgent (implement within 1 week, business-critical) ☐ High (implement within 2–4 weeks, significant impact) ☐ Normal (implement within 4–8 weeks, standard change) ☐ Low (implement as convenient, minor impact)
2. Change Description¶
Current Situation¶
Describe how things work now:
Proposed Change¶
Describe the proposed change in detail:
Reason & Justification¶
Why is this change needed?
☐ Customer request ☐ Compliance/regulatory requirement ☐ Improvement to efficiency ☐ Improvement to quality ☐ Improvement to H&S ☐ Improvement to environment ☐ Cost reduction ☐ Risk mitigation ☐ Other: _________________
Detailed justification:
Expected Benefits¶
What benefits will result from this change?
3. Impact Assessment¶
Evaluate the impact of the change across key areas:
| Area | Impact Level | Details |
|---|---|---|
| Quality — impact on product/service quality, customer satisfaction, specifications | ☐ None ☐ Low ☐ Medium ☐ High |
_________________ |
| Environmental — impact on environmental footprint, compliance, processes | ☐ None ☐ Low ☐ Medium ☐ High |
_________________ |
| Health & Safety — impact on H&S risks, incidents, hazards, working conditions | ☐ None ☐ Low ☐ Medium ☐ High |
_________________ |
| Legal/Regulatory — impact on compliance, standards, regulations, certifications | ☐ None ☐ Low ☐ Medium ☐ High |
_________________ |
| Resources — impact on budget, staff, training, time, materials | ☐ None ☐ Low ☐ Medium ☐ High |
_________________ |
| Customer — impact on customers, clients, delivery, SLAs, contracts | ☐ None ☐ Low ☐ Medium ☐ High |
_________________ |
Documents Affected¶
List documents that require update/revision:
4. Implementation Plan¶
Outline how the change will be implemented:
| Step | Action | Timeline | Responsibility |
|---|---|---|---|
| 1 | _________________ | _________________ | _________________ |
| 2 | _________________ | _________________ | _________________ |
| 3 | _________________ | _________________ | _________________ |
| 4 | _________________ | _________________ | _________________ |
Implementation Resources Required¶
Specify staff, budget, equipment, external support needed:
Communication Plan¶
Who needs to be informed and how?
5. Risk Assessment¶
Risks of Change¶
What could go wrong with this change?
| Risk | Likelihood | Impact | Mitigation |
|---|---|---|---|
| _________________ | _________________ | _________________ | _________________ |
| _________________ | _________________ | _________________ | _________________ |
Risks of Not Changing¶
What are the consequences of not making this change?
6. Approval & Decision¶
Management review and approval:
| Field | Details |
|---|---|
| Decision | ☐ Approved (proceed with change) ☐ Rejected (do not proceed) ☐ Deferred (revisit at future date) |
| Approver Name | _________________ |
| Approver Role | _________________ |
| Approval Date | _________________ |
| Signature | _________________ |
Approver Comments¶
Conditions of Approval (if any)¶
Two-tier approval: - CEO (Dragos Ciordas) approves Urgent/High priority or major scope changes - Operations Manager (Sean Ashton) approves Normal/Low priority changes
7. Implementation Record¶
Complete after change is implemented:
| Field | Details |
|---|---|
| Date Implemented | _________________ |
| Verified by (name) | _________________ |
| Implementation Issues | ☐ None ☐ Minor ☐ Significant |
| Issues Description | _________________ |
Effectiveness Confirmation¶
Did the change achieve intended results?
| Question | Response | Details |
|---|---|---|
| Implementation successful | ☐ Yes ☐ No ☐ Partial |
_________________ |
| Expected benefits realized | ☐ Yes ☐ No ☐ Partial |
_________________ |
| No unintended consequences | ☐ Yes ☐ No | _________________ |
| Staff trained/competent | ☐ Yes ☐ No | _________________ |
| Effectiveness confirmed | ☐ Yes ☐ No | _________________ |
Lessons Learned¶
8. Post-Implementation Sign-Off¶
| Role | Name | Signature | Date |
|---|---|---|---|
| Change Requester | _________________ | _________________ | _________________ |
| Implementer | _________________ | _________________ | _________________ |
| Verifier | _________________ | _________________ | _________________ |
| Operations Manager | Sean Ashton | _________________ | _________________ |
9. Change Register Update¶
- ☐ Change recorded in change log/register
- Implementation Status: ☐ Planned
☐ In Progress
☐ Completed
☐ Rolled Back
Related Documents¶
- HPROC07: Management of Change Procedure
- HPROC10: Document Control Procedure
- HPROC09: Training & Competence Procedure
- HPOL15: Change Management Policy
Document Footer¶
Retention: 3 years from implementation Storage: CRGI Secure Document Management System Access: Requester, Implementer, Operations Manager, CEO Classification: CRGI Information — Internal Use Only
END OF FORM